Effects of a low-fat diet compared with those of a high-monounsaturated fat diet on body weight, plasma lipids and lipoproteins, and glycemic control in type 2 diabetes

Aug 24, 2004The American journal of clinical nutrition

How low-fat and high-monounsaturated fat diets affect weight, blood fats, and blood sugar control in type 2 diabetes

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Abstract

Body weight decreased significantly by 1.53 kg in patients with type 2 diabetes following a low-fat diet.

An ad libitum low-fat, high-carbohydrate diet led to significant weight loss in individuals with type 2 diabetes.
Plasma total, LDL-, and HDL-cholesterol concentrations tended to decrease during both the low-fat and high-monounsaturated fat diets.
There were no significant changes in plasma triacylglycerol concentrations or glycemic control between the two diets.
Insulin sensitivity and glucose disposal did not differ significantly between the low-fat and high-monounsaturated fat diets.

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BACKGROUND: An important therapeutic goal for patients with type 2 diabetes is weight loss, which improves metabolic abnormalities. Ad libitum low-fat diets cause weight loss in nondiabetic populations. Compared with diets higher in monounsaturated fat, however, eucaloric low-fat diets may increase plasma triacylglycerol concentrations and worsen glycemic control in persons with type 2 diabetes.

OBJECTIVE: We investigated whether, in type 2 diabetes patients, an ad libitum low-fat diet would cause greater weight loss than would a high-monounsaturated fat diet and would do this without increasing plasma triacylglycerol concentrations or worsening glycemic control.

DESIGN: Eleven patients with type 2 diabetes were randomly assigned to receive an ad libitum low-fat, high-carbohydrate diet or a high-monounsaturated fat diet, each for 6 wk. The diets offered contained 125% of the estimated energy requirement to allow self-selection of food quantity. The response variables were body weight; fasting plasma lipid, lipoprotein, glucose, glycated hemoglobin A(1c), and fructosamine concentrations; insulin sensitivity; and glucose disposal.

RESULTS: Body weight decreased significantly (1.53 kg; P < 0.001) only with the low-fat diet. Plasma total, LDL-, and HDL-cholesterol concentrations tended to decrease during both diets. There were no interaction effects between diet and the lipid profile response over time. Plasma triacylglycerol concentrations, glycemic control, and insulin sensitivity did not differ significantly between the 2 diets.

CONCLUSION: Contrary to expectations, the ad libitum, low-fat, high-fiber diet promoted weight loss in patients with type 2 diabetes without causing unfavorable alterations in plasma lipids or glycemic control.

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Effects of a low-fat diet compared with those of a high-monounsaturated fat diet on body weight, plasma lipids and lipoproteins, and glycemic control in type 2 diabetes

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